In the nursing home setting, significant weight loss is defined as loss of 5% or more in the last 30 days or 10% or more in the last 180 days. Much weight loss can be prevented in the nursing home with proper care.
What are risk factors for weight loss?
- Required assistance to eat or drink
- Choking/swallowing problem
- Refusals of food and fluids
- Decreased meal consumption
- Visual impairments
- Poor condition of teeth that may cause pain with eating and problems chewing
- Poor fitting dentures
- Chronic pain
- Medication side effects and interactions
- Swallowing difficulties
- Taste alterations
- Smells of urine and stool in the nursing home
What can the nursing home do to reverse weight loss?
- Encourage foods based on resident’s likes and dislikes
- Request order for nutritional supplements that are calorie dense
- Schedule weekly weights
- Encourage a relaxed mealtime where intake is not rushed
- Request dietitian consultation
- Initiate intake and output monitoring (if not eating, probably not drinking, and some weight loss may be due to fluid loss)
- Evaluate and document all meal consumption
- Update the care plan with new nursing interventions
- Request a dental evaluation, if necessary to treat poor condition of teeth or dentures, which may resolve chewing difficulties
- Request social services to consult if depression is a likely cause
- If medication side effects are a likely cause, consult with the physician or consultant pharmacist
Questions you can ask the nursing home regarding weight loss:
- How does the nursing home determine the cause of weight loss in residents?
- How flexible is the nursing home in tailoring meals and foods to individual preferences?
- Does the nursing home have a program to rapidly and correctly notice change in nutrition?
- How does the nursing home address issues that may affect the eating environment?